Certificate of Continuity Healthcare Insurance Reference No : 0802516473 Place of Issue: UAE Date of Issue: 30-10-2016 This is to certify that the member(s) listed in section 2 is/are insured with Sukoon under the below mentioned healthcare policy. Please note that this certificate is valid for 30 days. 1. Policy Detail Policy Number 132465 Policyholder Name Policyholder Name Policy Type Policy-Type-001 2. Member Details Name Employee Number Card Number Gender Relation Nationality Date of Birth Coverage Start Date Coverage Expiry Date Name Employee Number Card Number Gender Relation Nationality Date of Birth Coverage Start Date Coverage Expiry Date 3. Declaration This certificate is issued upon member’s request. This certificate does not itself represent any legal binding. It serves as an intimation of coverage subject to terms and conditions of the healthcare policy. All dates, benefits, limitations and exclusions are as described in the master healthcare policy. Authorized Signatory Company Stamp